Senior Business Analyst, Command Center
Honolulu,
Hawaii
HMSA
Research and Data analysis Provide quality, objective, and professional analysis of relevant topics Gather and analyze information to identify trends, issues, innovations, and potential problems and solutions related to internal operations ...
7d
Nurse Reviewer - Clinical Review Unit
Kapolei,
Hawaii
HMSA
Utilize medical necessity criteria from established medical policies and clinical practice guidelines to render precertification determinations as described in the Medical Management UM work plan. This detailed clinical judgment includes ev...
9d
Supervisor, Membership Servicing
Honolulu,
Hawaii
HMSA
Monitor the performance and address issues with any business partners or vendors that supports the Members Servicing Department. Build relationships with both internal and external customers to include members and employer groups to address...
10d
Manager, Provider Research
Honolulu,
Hawaii
HMSA
Manage staff, ensuring provider inquiries are responded to timely, accurately, and professionally. Resolve complex provider inquiries. Respond to and oversee staff responding to CMS demand letters. Participate in ad hoc projects to help enh...
10d
Encounters System Analyst I
Honolulu,
Hawaii
HMSA
Analyzes encounter system processes within HMSA and external partners. Coordinates and reconciles exchange of data with external entities. Researches various claim-member-provider scenarios to determine root cause of data submission errors....
11d
Encounters System Analyst II
Honolulu,
Hawaii
HMSA
Sustains strong knowledge of encounter system processes within HMSA and external partners. Coordinates and reconciles data exchange with external entities, monitoring quality. Researches complex claim-member-provider scenarios to determine ...
11d
Senior Encounters System Analyst
Honolulu,
Hawaii
HMSA
Sustains mastery of encounter system processes within HMSA and external partners, for multiple lines of business. Monitors trends in data exchange with external entities and recommends adjustments as needed. Researches highly nuanced claim-...
11d
Accounting Analyst II
Honolulu,
Hawaii
HMSA
Coordinates various projects as assigned. Develops system requirements, test plan, test scenarios, test cases, anticipated test results and objectives and acceptance criteria. Also, performs testing, communicates status/concerns to appropri...
16d
Manager, Configuration
Honolulu,
Hawaii
HMSA
Provide strategic management and direction for the configuration of health plan products, provider networks, and reimbursement methodologies to ensure alignment with business requirements, state and federal regulations, and accreditation st...
18d
Performance Reporting Analyst, Command Center
Honolulu,
Hawaii
HMSA
Data Analysis and Reporting Conduct high quality, objective analysis to support performance optimization and strategic initiatives. Collect, interpret, and evaluate Key Performance Indicators (KPIs) and related information to identify trend...
19d